| Objective to explore the effect of oral administration and external washing of traditional Chinese medicine on collagen induced tendinitis rats through clinical research and animal experimental research,so as to provide more choices for clinical treatment of tendinitis.Objective: Methods:(1)Clinical research: retrospective study from July 2019 to July2020 Methods: Patients with calcaneal tendinitis were randomly divided into western medicine group(group A),Chinese medicine oral group(group B),Chinese medicine external washing group(Group C),Traditional Chinese medicine combined with external washing group(group D)its Chinese and western medicine group according to the instructions to take losuprofen sodium tablets,the Chinese medicine oral group took Chinese medicine prescription regularly and quantitatively,and the external washing group took scald and wash the affected part regularly.The combination group was treated with oral Chinese medicine and external Chinese medicine.After treatment,the VAS score and AOFAS score of the four groups were compared before and after treatment.Objective and accurate evaluation of the four treatment groups(2)Animal experiment: 36 healthy male SPF SD rats(200 ± 20g)were randomly divided into 6 groups with 6 rats in each group.The six groups were blank group(group A),model group(group B),loxoprofen sodium group(Group C),oral Chinese medicine group(Group D),external Chinese medicine washing group(Group E),combined oral Chinese medicine and external washing group(Group F).In addition to the blank group,the other five groups used calf type II collagen to prepare the rat model of tenosynovitis.After the successful establishment of tenosynovitis model,rats in groups a,B and E were given normal saline by gavage;group C was given loxoprofen sodium by gavage;group D was given experimental Chinese medicine by gavage;The rats in Group E were treated with traditional Chinese medicine for external washing,while the rats in group F were treated with oral administration combined with external washing.Based on the center of Achilles tendon,the circumference of left hind leg was measured and recorded before modeling,on the first day after modeling and on the 21 st day after treatment;blood was taken from abdominal cavity after anesthesia and intoxication on the 21 st day after modeling,and the levels of serum IL-1 β,IL-6,TNF-α,IFN-γ were detected by ELISA and Western blot The expressions of SCX,TGF-β and samd3 protein in the Achilles tendon cells were detected.The Achilles tendon tissues were stained with he and observed histologically.Results:In the clinical study,there was no significant difference in VAS score and AOFAS score among the four groups before diagnosis and treatment(P > 0.05),and there was significant difference after treatment compared with before treatment(P < 0.01);compared with the other three groups,the Chinese medicine oral and external washing group had more advantages in reducing VAS score,increasing AOFAS score(P < 0.05);The curative effect of oral administration group and external washing group was significantly better than that of Western medicine group(P < 0.05).The pain symptoms of all patients were relieved in varying degrees,and no adverse reactions occurred.The effect of the group of internal and traditional Chinese medicine and the washing group was more obvious than that of the western medicine group(P > 0.05).On the first day after modeling,there was a significant difference between each model group and that before modeling(P < 0.01);Compared with the blank group,each model group increased significantly,with a significant difference(P < 0.05);there was no significant difference between each treatment group and the model group(P > 0.05).On the 21 st day after modeling,there was significant difference between the treatment groups and the first day after modeling(P < 0.05);there was no significant difference between the blank group and the model group(P > 0.05)Compared with the model group,the treatment groups had significant differences(P < 0.05);the circumference of the left hind leg in the combined group was less than that in the loxoprofen sodium group,the oral group and the external washing group,with significant differences(P < 0.05),and there was no statistical significance compared with the blank group(P > 0.05)The difference was statistically significant(P < 0.05);After modeling,the serum levels of IL-1β、IL-6、TNF-ɑ and IFN-γ in each model group were measured After drug treatment,there were significant differences between loxoprofen sodium group,oral Chinese medicine group,external Chinese medicine washing group and model group(P < 0.01),The serum levels of IL-1β、IL-6、TNF-ɑ and IFN-γ in the combined group were lower than those in the other three groups,with significant difference(P < 0.05);the serum levels of IL-1β、IL-6、TNF-ɑ and IFN-γ in the combined group were lower than those in the oral group and the loxoprofen sodium group,with significant difference(P < 0.05);the serum levels of IL-1 β,IL-6,TNF-α and IFN-γ in the oral group were lower than those in the oral group and the loxoprofen sodium group,with significant difference(P < 0.05)The serum levels were significantly lower than those in loxoprofen sodium group(P < 0.05).Western The expression of SCX,TGF-β and p-samd3 protein in each group was different,the expression level of group A was the lowest,the expression level of group B,C,D,e and F was increased,the comparison between groups was statistically significant(P< 0.05),the expression level of traditional Chinese Medicine combined group was higher than that of other treatment groups,the difference was statistically significant(P < 0.01);the expression level of each treatment group was higher than that of model group,the difference was statistically significant The expression levels in the oral group and the external washing group were higher than those in the western medicine group,and the difference was statistically significant(P < 0.05).Observation results of rat Achilles tendon tissue: in the model group,the Achilles tendon tissue was hyperemia and edema,the circumference was thicker than that of the healthy side,and the elasticity was decreased and hardened.The degree of congestion and edema of Achilles tendon in each treatment group was reduced,and the tendinous tissue connection was found,especially in the combination group.Conclusion: Traditional Chinese medicine treatment and Western medicine treatment can play an active role in the treatment of calcaneal tendinitis.Compared with western medicine treatment,traditional Chinese medicine treatment has obvious advantages.The combined treatment of oral and external washing of traditional Chinese medicine has a more significant effect on calcaneal tendinitis,which can alleviate the pain and discomfort of patients to a greater extent.Both traditional Chinese medicine and Western medicine have therapeutic effects on rats with calcaneal tendinitis,which can reduce the degree of swelling and the levels of IL-1β、IL-6、TNF-ɑ and IFN-γ in serum.The combination of oral administration and external washing of traditional Chinese medicine has more significant effect on calcaneal tendinitis. |
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